Healthcare Provider Details

I. General information

NPI: 1265583900
Provider Name (Legal Business Name): GEORGEANN NEUZIL PMCNS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/16/2007
Last Update Date: 07/21/2022
Certification Date: 06/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

571 HIGH ST STE 16
WORTHINGTON OH
43085-4132
US

IV. Provider business mailing address

778 S CASSINGHAM RD
COLUMBUS OH
43209-2404
US

V. Phone/Fax

Practice location:
  • Phone: 614-638-0060
  • Fax:
Mailing address:
  • Phone: 614-638-0060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberRN141132
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: